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  • 期刊

2007-2012年全國發展遲緩兒童通報概況

Overview of the Reporting of Developmentally-Delayed Children in Taiwan between 2007 and 2012

摘要


早期療育在我國立法與推動已邁入第21個年頭。過去為了要快速推展各項業務,以達到發展遲緩兒童都能被「早期發現與早期治療」,各個縣市盡量結合當地資源提供相關服務,因而產生多種不同的早療服務模式。雖然目前仍難以確定各類服務模式的成效,早期發現需要療育的孩子仍是成功早療的重要因素。然而,早年偏遠地區因醫療資源取得不易,對於兒童發展遲緩也缺乏認識,造成通報率偏低也進而使得多數符合發展遲緩定義之兒童沒有接受治療。為了解近年來各地區的通報概況,並對原住民與非原住民兒童通報率進行比較,本研究以內政部兒童局公布之2007-2012年「發展遲緩兒童早期療育服務個案通報概況」,並採用內政部當年度現住人口數(依性別、年齡分)為分母,推估與比較各縣市原住民與非原住民兒童通報率,供服務制定者與供應者參考。本研究顯示,2007-2012年,全國通報率呈現逐年上升趨勢,且大多數縣市6年期間的平均通報率與全國的數值並無顯著差異。2012年之非原住民兒童之通報率較2007年增加2.59,原住民通報率則是增加10.34‰。2008年起全國原住民兒童通報率即高於非原住民兒童。2007-2012年期間通報率表現亮眼的縣市有南投縣、花蓮縣、台東縣等。實證醫學資料已顯示早期療育是項高報酬率的公共投資。高通報率的縣市多屬於都市化低的城鄉。這些地區的療育相關資源分佈不均勻的狀況可能更顯著。此外,因為在各縣市發現通報個案所使用的篩檢量表、方法及標準可能不一致,致使高通報率並不一定等於良好的通報品質。因此,除了注重通報率的提升之外,品質的提升也是我們應當注重的部分。所以,為了達到發展遲緩兒童都能被「早期發現與早期治療」,各地通報服務制定者與供應者仍宜定期審視通報階段之執行成果,中央主管機關亦應提出一個制度化和長遠性的規劃與支持高品質的通報作業,將有效的療育服務即時輸送給住在高通報率又低城市化的地區之通報個案,並對通報率低的縣市檢視其相關政策之執行與落實。

關鍵字

早期療育 發展遲緩 通報率

並列摘要


Successful early intervention (EI) depends on the early detection of children who exhibit a delay in development or are at risk for developmental problems and providing these children and their families with timely integrated services delivered by social welfare, health, and educational professionals. To understand the difference in reporting rates among cities and counties, we analyzed registry data on the reported number of early intervention services (EISs) provided to developmentally delayed children from 2007 to 2012 published annually by the Department of Statistics, Ministry of the Interior. The information included the number of new cases reported each year according to the patients' ages at the time that the cases were reported, reporting area (city/county), gender, and ethnicity. The reporting rate in each city or county was estimated using the number of age-and ethnicity-specific children in each year in the database obtained from the Ministry of Interior as the denominator. The study was exempted from review by the Joint Institutional Review Board of Taipei Medical University. From 2007 to 2012, the national reporting rates increased yearly. The 6-year average reporting rates of most cities or counties did not deviate significantly from the national average rate. Compared with the rates observed in 2007, the reporting rates of nonaboriginal and aboriginal children increased by 2.59 per 1000 and 10.34 per 1000, respectively, in 2012. The annual national reporting rates for aboriginal children exceeded those for nonaboriginal children in 2008. The reporting rates of Nantou, Taitung, and Hualien Counties were persistently higher than those of other cities and counties. Previous studies have confirmed that EI is effective The best practice model for EIS entails collaboration among professionals and providing coaching services in a natural environment. The EIS-related health or educational resources of less urbanized areas are generally more limited. Our results indicated that the reporting rates of less urbanized areas were higher, suggesting that the government must establish teams of social welfare, health, and education professionals that deliver EISs in less urbanized areas, thus enabling developmentally delayed children in those areas to lead a normal life.

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